PROCEDURAL DERMATOLOGY PC
NPI 1164299004
Dermatology in New York, NY

Active since December 11, 2023
4925 BROADWAY, NEW YORK, NY 10034(718) 255-7546(917) 975-6272 Get Directions Write a Review

NPPES record last updated: February 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Procedural Dermatology Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROCEDURAL DERMATOLOGY PC (NPI 1164299004) is a healthcare organization registered as a dermatology in New York, New York and active in the NPI registry since December 2023. The organization maintains a secondary practice location in Corona and lists Irene Vergilis-kalner, President, as its authorized official.

NPPES Registry Identity

NPI1164299004
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePROCEDURAL DERMATOLOGY PC
Location Address4925 BROADWAYNew York, NY 10034-3101
Mailing Address262 Central Park W Ste 1dNew York, NY 10024-3512 · (718) 255-7546 · Fax (917) 975-6272
Fax(917) 975-6272
Organization SubpartNo
Authorized OfficialIrene Vergilis-kalnerPresident · (917) 804-4553
Enumeration DateDecember 11, 2023
Last NPPES UpdateFebruary 28, 2024
NPPES CertifiedFebruary 28, 2024
✔ NPI 1164299004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
4925 BROADWAY, New York, NY 10034

Secondary Practice Location 1

Location 13773 103rd StCorona, NY 11368-3465 · Phone (718) 255-7546 · Fax (917) 975-6272

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Procedural Dermatology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Procedural Dermatology PC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Emergency Medicine
NPI 1073740460
2727 OCEAN PKWY STE L1
Brooklyn, NY 11235
(718) 975-7546
✔ PECOS✔ Accepts Medicare20 mi
Pathology
NPI 1912068420
155 CRYSTAL RUN RD
Middletown, NY 10941
(845) 703-6999
✔ PECOS✔ Accepts Medicare46 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Procedural Dermatology PC's NPI number?

The NPI number for Procedural Dermatology PC is 1164299004. It was assigned to this organization in the NPPES registry on December 11, 2023.

Where is Procedural Dermatology PC located?

Procedural Dermatology PC is located at 4925 Broadway, New York, NY 10034. The listed phone number is (718) 255-7546.

What is Procedural Dermatology PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Procedural Dermatology PC enrolled in Medicare?

Yes. Procedural Dermatology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Procedural Dermatology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Procedural Dermatology PC, in Emergency Medicine and Pathology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Procedural Dermatology PC was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.